The most difficult challenge for health information exchanges is the development of a sustainable business model, according to the 2007 “Fourth Annual Survey of Health Information Exchange at the State, Regional and Community Levels,” by the Washington-based e-Health Initiative.
Twenty of the 130 initiatives included in the 2007 survey are just getting started, 68 are in the process of implementation, 32 are operational, five are no longer moving forward, and five did not respond to the survey question regarding stage of development.
The survey found that increasingly, efforts are involving all stakeholders within the system, including clinicians, community health centers, consumers, employers, health plans, hospitals, laboratories, pharmacies, public health agencies and government.
Despite difficulties with achieving sustainability, the 2007 survey report indicates that at least 32 HIEs have made progress, identifying themselves as “operational” or “transmitting data that is used by stakeholders,” as compared to 26 in 2006.
For the first time since the survey was conducted, the government was not cited as the top provider of up-front funding for all HIEs.
Detailed survey results can be found here.